An invasive tubular device can be guided to reach a tissue object under ultrasonographic visualization by an apparatus that measures an insertion angle and a depth. Insertion angle of an invasive tubular device can be adjusted to various positions of an ultrasound transducer in relation to a center of the tissue object. The apparatus adjusts angulation of the invasive tubular device by using ultrasonographic visual information of a set of insertion angle and depth of the invasive tubular device to reach the tissue object. One major drawback of the apparatus is a necessity to insert an invasive tubular device manually while visualizing insertion procedures. In-process visualization of insertion procedures of invasive devices is especially important for small lesions, lesions located deep in a body, lesions located near vital structures or lesions that move during invasive procedures by physiologic bodily function such as breathing, heartbeat or pulsating blood vessels, to increase accuracy of the insertion and to reduce chances of potential complications of the procedure. Manual procedures are well-known for their unpredictability and variability of successful outcome, whether it is for inserting an invasive tubular device, for obtaining a tissue sample or for marking a particular site for further interventions. Although stereotactic placement of an invasive tubular device by in-process ultrasound visualization would reduce the unpredictability and variability to an extent, it would continue to be an important issue as long as the invasive tubular device is manually handled by a human operator whose prior experiences and technical dexterity would vary.
This technical challenge by a human factor may be overcome if stereotactic placement of an invasive tubular device would be automated and powered by an apparatus which minimizes operator's input. The apparatus may be operable by a single hand of an operator, which monitors a procedure real-time and consistently produces an expected range of successful outcome of the procedure. Simple mode of automated operations by the apparatus makes procedural success depend less on an operator but more on accuracy and reliability of the apparatus. Success rate of procedures would go higher if the apparatus requires less input, has less interactive components for optimum performance and has fail-safe safety measures to prevent unintended harm to a subject undergoing invasive procedures. A minimum set of input for correct positioning of an invasive tubular device would require a two-dimensional insertion angle and depth of the invasive device to reach a tissue object, which can be verifiably obtainable by our prior inventions using real-time ultrasonographic visualization of a tissue object. Two-dimensional measurements and visualizations are advantageous to three-dimensional ones since the vast majority of current imaging displays are two-dimensional. Three-dimensional targeting of an object in a two-dimensional display system requires separate and significant training on the part of an operator since human perception of a depth at an angle to a two-dimensional panel of display is not natural.
A minimum set of device assemblies would include a stereotactic positioning system, a powered propulsion system of an invasive tubular device and a non-reusable invasive tubular device. The powered propulsion system should deliver adequate forward and backward linear force to an invasive device for its penetration into and retrieval from a tissue. It should be instantaneously controllable for introduction of the invasive device into a tissue to avoid harm to vital structures such as blood vessels. These may be accomplished by using a design to convert rotational torque to linear displacement for propulsion at a range of ratio between rotational and linear displacements. A propulsion force and a degree of precision of control of linear displacement of an invasive tubular device increase on a higher number of rotations per a unit of linear displacement. The apparatus should be configured for fail-safe measures for safety, the most important of which is to limit penetration of an invasive tubular device into a tissue. Unintended penetrations and blind operations are most commonly associated with procedural complications such as puncturing blood vessels and various natural body cavities. Degree of ease in withdrawing the invasive tubular device is equally important as well since even a well thought-out pre-procedure planning may sometimes turn out to be inadequate to deal with unpredictable nature of a human body. These would be addressed by in-process visualization of the procedures and full controllability of linear movement of an invasive tubular device.